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Biomedical subjects

S Morax

Publications and source records attributed to S Morax.

At least 19 recordsLinked to original sources
PubMed2006

[Involutional ptosis].

Aponeurotic defects and disinsertion of the levator aponeurosis are responsible for acquired involutional ptosis. The typical clinical findings in aponeurotic defects are high or moderate ptosis, good to excellent levator function, thinning of the eyelid above the tarsus, high to absent lid crease, and normal Müller's muscle function. The purpose of the treatment is to repair the defect or to advance the aponeurosis on the tarsus. This surgery can be done via the anterior approach with aponeurotic surgery or via the posterior approach with Müller's muscle conjunctival resection. In all cases, upper lid blepharoplasty is down.

Aged↗
PubMed2006

[Three-dimensional computer-assisted modeling of the orbital cavity and the eyelids].

PURPOSE: To develop a virtual model of the orbital cavity and the eyelids using a three-dimensional model. METHODS: Amapi Designer 7 and Carrara 3 Studio (Eovia, Mountain View, CA, USA) software were used to obtain 3D models of the orbital cavity and the eyelids. Three-dimensional creation is divided into two main processes. In the modeling process, a 3D model of the orbit, the arterial supply, and the eyelids are created using polygonal meshes and surgical tools with parametric surfaces. In the rendering process, colors are arbitrarily chosen to make elements in the model easier to read. A virtual camera is adjusted and light sources are created to produce virtual simulations of the orbit and the eyelids. RESULTS: Surgical techniques were illustrated with 3D models. Ptosis surgery (resection of the levator muscle and Müller's muscle conjunctival resection) and the transconjunctival approach to lower eyelid blepharoplasty were described step by step. CONCLUSION: Three-dimensional models have applications in many medical fields, providing representation of anatomical structures. They can be used to depict the anatomy of the orbital region in a realistic way. Three-dimensional computer-generated images are an aid in teaching residents in orbital anatomy and surgery.

Blepharoplasty↗
PubMed2006

[Optic nerve sheath meningioma: diagnosis and new treatment options, a case study of monocular blindness during pregnancy].

Optic nerve sheath meningiomas are challenging lesions to manage. We report here a case of primary optic nerve sheath meningioma in a pregnant woman with sudden unilateral vision loss. Then we review the current literature on the subject, prognosis factors, and report the results of fractionated radiotherapy and current therapeutic guidelines. Pregnancy may accelerate growth of meningiomas and this diagnosis must be considered in all cases of optic neuropathy in pregnant woman.

Adult↗
PubMed2005

[Adenocarcinoma in a pleomorphic adenoma of the lacrimal gland: a case study].

PURPOSE: To report a patient with an adenocarcinoma in a pleomorphic adenoma of the lacrimal gland. Adenocarcinoma constitutes a distinct group of epithelial malignancies of the lacrimal gland. METHODS: The clinical presentation, workup, surgical approach, and pathological findings were reviewed. RESULTS: A 56-year-old man presented with a 3-month history of a lacrimal fossa mass. This patient presented a painless mass in the upper outer eyelid with significant displacement of the globe. The tumor was localized to the lacrimal gland. Radiological investigations showed a round, well-defined lesion in the fossa of the lacrimal gland. We performed a lateral orbitotomy; en bloc resection was accomplished. The final specimen showed an adenocarcinoma in a pleomorphic adenoma. No recurrences were detected during follow-up. CONCLUSION: Although adenocarcinoma has rarely been reported in association with a pleomorphic adenoma of the lacrimal gland, this combination can exist. If the malignant tumor is limited in the pleomorphic adenoma, the prognosis appears to be better than in cases of local extension. Adjuvant therapy, radiation or others, are not useful.

Adenocarcinoma↗
PubMed2005

[Reconstruction of full-thickness lower eyelid defects].

This review covers the techniques of reconstruction of large full-thickness defects of the lower eyelid. The authors describe tree cases of basal cell carcinoma of the lower eyelid, with large excision of the tumor. We excised the tumor and examined the edges with an extemporaneous histological exam. Reconstruction combined grafts and flaps. The advantages and disadvantages of the various techniques of lower-eyelid reconstruction are discussed.

Basal Cell Carcinoma↗
PubMed2004

[Complications of blepharoplasty].

Blepharoplasty complications are infrequent, most often minor and transitory, rarely major and permanent with functional or esthetic consequences. Treatment is above all preventive: screening at risk patients with a history of ophthalmic problems, but also general illnesses that would contraindicate blepharoplasty. Patients must be informed of possible risks through informative booklets with the most important points underlined. Complications can be purely ophthalmological, the more serious sequelae being partial or complete visual loss due to ischemic optical neuropathy, with very poor prognosis, or more rarely compression of the ocular globe by intraorbital hemorrhage, which has a better prognosis provided the origins are quickly recognized and treated immediately. Other visual complications include oculomotor problems, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis on the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring and eyelid fold anomalies. The most serious esthetic complication is the malposition of the lower eyelid, which can manifest as retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are quite often minor, sometimes reversible, but at times major, with psychological, esthetic and functional consequences that are difficult for the patient. Other local complications also arise: enophthalmia with a sunken lid, as well as under- and overcorrection. General complications can include scarring related to pigmentation problems and residual hematomas, and exceptionally infections going as far as the orbital fat tissue. Finally, other complications are related to new laser surgical techniques that are responsible for ectropion of the lower eyelid and even burns or residual redness, or complications related to periocular injections of filling material. A comprehensive review of prevention, diagnosis, and management of complications after blepharoplasty is presented.

Blepharoplasty↗
PubMed2004

[Medical treatment of dysthyroid orbitopathy].

The majority of Graves' patients have mild and nonprogressive ocular involvement that does not require aggressive treatment. Local supportive measures such as wearing tinted lenses, proper eyelid hygiene, and the use of wetting agents or gels are usually sufficient to obtain symptomatic relief until eye disease becomes inactive. Smoking must be stopped and euthyroidism controlled. Management of severe forms (10% of patients) is often difficult and does not provide consistently favorable results. The use of glucocorticoids is a well-established method of treatment, indicated in severe inflammatory forms as well as in complicated forms of optic neuropathy, ocular hypertension, and corneal exposure, and are used orally or intravenously, at high doses and for prolonged periods of time. Prisms are useful in cases of diplopia. Favorable effects are reported in slightly more than 60% of cases. Glucocorticoids can be combined with orbital radiotherapy in patients with severe orbitopathy.

Anti-Inflammatory Agents↗
PubMed2004

[Orbital decompression for dysthyroid orbitopathy: a review of techniques and indications].

Orbital bony decompression has a definite place in the management of severe manifestations of dysthyroid orbitopathy such as optic neuropathy, exposure keratitis, and exophthalmos. This surgical procedure can be undertaken when medication and radiation therapy fail. Esthetic and functional results are globally satisfying and explain the interest taken in this technique. This article will describe the development of this procedure and will outline the surgical techniques and their complications. It emphasizes the multifactor indications for this procedure.

Blepharoplasty↗
PubMed2003

[Steinert myotonic dystrophy and blepharoptosis surgery: 9 case reports].

UNLABELLED: Steinert myopathic dystrophy is a generalized, hereditary disease with bone, muscular, heart and ocular involvement. PATIENTS AND METHODS: This is a retrospective study of nine patients with significant blepharoptosis due to Steinert disease, who were treated at the Adolphe de Rothschild Ophthalmology Foundation over a period of 5 years. Ptosis was symmetric and major in all cases with poor levator excursion. Severity criteria were an absence of the Bell phenomenon and diminished orbicularis tone. A frontalis suspension was performed in eight cases with intentional undercorrection. The outcome was favorable in all cases, 2 with a slight overcorrection underwent a second operation DISCUSSION: conclusion: Surgical treatment of ptosis in Steinert disease is difficult because of a risk of lagophthalmic, keratopathy due to the severity of the disease, an absence of the Bell phenomenon and ophthalmoplegia. This surgery must be undertaken with caution, most often using a frontalis suspension. Undercorrection must be systematic, with the single goal of freeing the pupil in the primary position.

Adult↗
PubMed2003

[Surgical treatment of eyelid tumors].

After reviewing the general principles of eyelid reconstruction, the authors present reconstruction techniques with regard to the location and size of the eyelid defect. When the defect is less than one-quarter of lid length, direct suture is possible. When the defect is larger, reconstruction techniques differ for the upper and lower lid.

Cartilage↗
PubMed2003

[Advantages of a double approach to upper blepharoplasty associated with eyelid malpositions].

During upper blepharoplasty, myocutaneous excess and fat pads are treated using an anterior approach. Eyelid malpositions such as involutional ptosis or lid retraction could be associated and should be treated with associated procedures. Aponeurotic surgery on the levator muscle can make use of the same anterior approach, with the major difficulty of dosage. In cases of ptosis with a positive epinephrine test or minor muscular retraction, the Müller muscle-conjunctival surgery via a posterior approach seems to be more reproducible. Double-approach techniques are described.

Blepharoplasty↗
PubMed2002

[Intraocular high pressure in thyroid-associated orbitopathy: physiopathological mechanisms, diagnosis, and management. Three case reports].

PURPOSE: To determine the mechanisms and treatment of ocular hypertension in patients with thyroid-associated orbitopathy and to differenciate it from glaucomatous damage. DESIGN: Three case reports. METHODS: Retrospective review of clinical findings, course, and treatment of the three patients. RESULTS: Elevated intraocular pressure in thyroid-associated orbitopathy observed in the three cases may involve different physiopathological abnormalities such as disturbances of venous circulation, compression by infiltrative muscles, and long corticosteroid use. In the first two cases, defects demonstrated in the perimetry are in consistent with glaucomatous damage. In the third case, visual field abnormalities may be compatible with a glaucomatous disease, but all defects resolved after therapy. Treatement was of the greatest difficulty for the three cases, associating antiglaucomatous medication, steroids, orbital radiotherapy, orbital decompression and extraocular muscle surgery. Intraocular pressure was controlled in all cases. CONCLUSIONS: Elevated intraocular pressure in thyroid-associated orbitopathy is distinguished from glaucomatous disease by its physiopathological mechanisms, clinical course, visual field defects, and treatment. The management of this hypertension is closely related to the treatment of dysthyroid orbitopathy.

Adult↗
PubMed2001

[Orbital metastasis in malignant melanoma].

We report the case of a 60-year-old man presenting bilateral progressive proptosis with diplopia, weight loss, tachycardia, nervosity, and stomach pain. These signs seemed at first to favor a diagnosis of Graves'ophthalmopathy. Thyroid tests were negative and the initial orbital CT scan was considered normal. A new radiological investigation 4 months later in our hospital revealed typical hypertrophy of the extraocular muscles compatible with orbital metastasis. The systemic investigations demonstrated a pulmonary tumor, multiple hepatic lesions, and several pigmented nodules of gastric mucosa. The pathology of pulmonary and gastric specimens confirmed the diagnosis of malignant melanoma. The primary lesion remains unknown. The authors discuss the differential diagnoses of orbital metastasis and the radiological characteristics of orbital metastasis in malignant melanoma.

Diagnosis, Differential↗
PubMed2001

[Enucleation with on-the-table evisceration. Is it a good technique?].

PURPOSE: To evaluate the surgical technique of enucleation followed by an "on-the-table evisceration" and placement of a hydroxyapatite orbital implant wrapped by the patient's own sclera for the treatment of blind phthisis painful eyes. PATIENTS AND METHODS: In this single-center retrospective study, 50 consecutive patients undergoing an operation using the same surgical technique, between April 1993 and November 1999, were studied. Patients underwent enucleation, then the eyeball was eviscerated "on the table". The patient's own cleaned sclera was used to wrap a hydroxyapatite orbital implant, the posterior pole of the sclera was placed at the anterior pole of the implant. Conjunctival breakdown, sphere size, conjunctival discharge, the first signs of sympathetic ophthalmia motility, and cosmetic results were analysed. RESULTS: After an average follow-up of 13.3 months few complications were encountered: 4 cases (8%) of inclusion cyst and 3 cases (6%) of discharge. The implant placed had a diameter of 18 mm, 20 mm, 22 mm in, respectively, 48%, 48%, and 4% of the eyes. The prosthesis motility was good, medium, and poor in, respectively, 33 (78.6%) cases, 8 (19%) cases, and 1 (2.4%) case. The prosthesis tolerance was good, medium, and poor in respectively 86%, 10%, and 4% of the cases. CONCLUSION: The surgical technique of enucleation followed by an "on-the-table" evisceration and autologous sclera wrapping a hydroxyapatite implant is an easy procedure. It allows, on phthisis eyeballs, the placement of a large orbital implant for good cosmesis results, without major complications.

Adolescent↗
PubMed1997

[Orbital decompression in exophthalmos due to thyroid disease. Report of 69 cases].

Dysthyroid exophthalmos is due to mismatching of the orbit and its contents, essentially due to muscle enlargement, and, to a lesser degree, fat volumetric changes. Surgical treatment is designed to expand the orbital volume by bone removal or to reduce orbital contents by fat removal, or a combination of the two techniques. Our series consisted of 69 patients who underwent orbital decompression for proptosis, with osteotomy (12 cases) or associated with fat removal (57 cases). We obtained good results for all cases, and did not encounter any complications. Several factors now appear to play a role in the choice of surgical technique, particularly the preoperative radiologic (CT) examination which determines the muscular and fat involvement, wall orbital changes and appearance of the sinuses. Orbital fat removal seems to be useful in proptosis reduction in those cases in which fat is more involved and easy to remove. Anthral ethmoidal decompression is the best technique in the case of dysthyroid optic neuropathy.

Adult↗